Senior Safety: Understanding how diseases affect elderly can help protect them

Published: Wednesday, January 13, 2010

SARAH NIGHTINGALE

About five years ago, when Sgt. Ross Hester was working patrol, a cashier at a local convenience store asked him to check on an elderly couple who had pulled in for gas. They seemed disoriented, the cashier said.

Medical wristband with a radio transmitter built in to help locate missing persons.

He was right.

The couple, from the Hill Country, had set out hours before. When a wrong turn took them onto an unknown route, they kept driving for 300 miles, unsure of where they were or what they should do.

That was three years before the Texas Legislature enacted a statewide communication system to help find mentally impaired senior citizens.

"I think they are a really good idea," said Hester, a Lubbock Police sergeant. "(A Silver Alert) could have helped those people. I mean, nobody knew where they were."

But Silver Alerts alone can't keep seniors safe.

On Monday, police officials were preparing an alert for 70-year-old Lubbock resident Jim Hardy Clary, who left home for a doctor's appointment he didn't keep. He was found dead before a statewide alarm was raised.

Local health officials said understanding the symptoms of dementia might help safeguard elderly people who are at risk for getting lost.

While infections, tumors, and head injuries can all cause dementia, Alzheimer's disease is most commonly behind the condition, said Andrew Dentino, chief of geriatrics at Texas Tech's Health Sciences Center.

And while plaques and tangles degrade the brains of all Alzheimer's patients, the disease affects different people in different ways, he said.

According to Dentino, the part of the brain affected by the disease determines how a person's memory erodes - they might forget names but remember landmarks - and whether or not they hallucinate.

For patients who hallucinate, their risk for wandering might depend on how well they trust their caregiver.

"If they hallucinate, they may be at low risk or high risk, depending on their trust for the caregiver," Dentino said. "If they are suspicious, they might try to get out."

The stage of the disease may also indicate whether a patient will roam, he said.

"In the early to middle stages, when a person is willing to drive, that's when they are at risk," he said.

As the disease progresses, and a patient's ability to do simple tasks diminishes, the wandering will lessen, he said.

There have been 135 Silver Alerts statewide and two in Lubbock County since the program started in September 2007, said Tela Mange, a spokeswoman for the Texas Department of Public Safety. Hester said his department responds to many more reports that either don't qualify as a Silver Alert - five criteria must be met before information is broadcast statewide - or are solved relatively quickly.

While families might be reluctant to intervene in a loved one's ability to drive, simple triggers such as heavier-than-usual traffic might cause a patient to get lost.

"They can drive to the store one day, and the next day they can start driving and get lost," said Ann Laurence, senior director for education for the Health Sciences Center's Garrison Institute on Aging.

If a senior has lost the ability to recognize landmarks, driving should be discouraged, she said. "It can be a sensitive subject because people hate losing their independence."

Dentino said concerned caregivers can request a patient be re-evaluated by the Department of Motor Vehicles, essentially asking a third party to recommend the intervention.

But dementia patients are still at risk from wandering on foot, the experts said.

While Alzheimer's medications slow the disease and anti-anxiety pills might help mistrustful patients, Dentino said he often tells families there's no magic bullet.

"I tell families they need structure," he said.

Laurence said some assisted living centers have specially designed "memory disorder units" and Dentino said care at home can also become more structured.

"It can be adult day care, the senior center, or meals on wheels ... any way for us to eyeball the individual on a regular basis," he said.

But many patients wander at night, Laurence said.

"Are they cold, do they need to go to the bathroom ... or they may just be hungry?" she said. In such cases, an extra blanket or an apple might help wanderers stay put, she said.

For people at high risk for roaming, a program operated by the Lubbock County Sheriff's office and supported by the Pilot Club of Lubbock might offer the best chance of a quick and safe return.

"We put a transmitter on the individual," Sheriff Kelly Rowe said. "If they wander off, we have tracking equipment we use to zero in and locate them."

Rowe said Project Lifesaver is used by nine families in Lubbock County, including some seniors and some autism patients. The agency hopes to expand the program to more Alzheimer's patients, he said.